Recovery of Delayed Graft Function after Calcineurin Inhibitor Sparing Regimen in a Renal Transplant Patient with Calcineurin Inhibitor Toxicity: A Case Report.
10.4285/jkstn.2014.28.3.165
- Author:
Seok Hui KANG
1
;
Woo Sung YUN
;
Kyu Hyang CHO
;
Jun Young DO
;
Kyung Woo YOON
;
Jong Won PARK
Author Information
1. Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea. jwpark@med.yu.ac.kr
- Publication Type:Case Report
- Keywords:
Calcineurin inhibitor;
Sirolimus;
Delayed graft function;
Kidney transplantation
- MeSH:
Anuria;
Biopsy;
Calcineurin*;
Constriction, Pathologic;
Creatinine;
Delayed Graft Function*;
Diabetes Mellitus;
Humans;
Kidney Failure, Chronic;
Kidney Transplantation;
Male;
Middle Aged;
Necrosis;
Renal Dialysis;
Sirolimus;
Steroids;
Tacrolimus;
Transplants;
Ureter
- From:The Journal of the Korean Society for Transplantation
2014;28(3):165-168
- CountryRepublic of Korea
- Language:English
-
Abstract:
The recipient candidate was a 51-year-old male with end-stage renal disease owing to diabetes mellitus. The initial immunosuppressive regimen included basiliximab for induction and tacrolimus, mycophenolate mofetil, and steroids. Urine output was 413 mL/day on the operative day and 100 mL/day on the postoperative day (POD) 1. There was no definite stenosis of the ureter or vessels. He had anuria on POD 2~4 and he had undergone hemodialysis. His serum creatinine level did not decrease. Therefore, a graft biopsy was performed on POD 4. The pathologic finding was consistent with acute calcineurin inhibitor (CNI) toxicity. There was no evidence of rejection or acute tubular necrosis. Anuria continued on POD 6; therefore, we started sirolimus instead of a CNI based regimen. Graft function was gradually recovered 1 day after reduction of CNI dose and hemodialysis was stopped. The serum creatinine level was normalized on POD 10. He was discharged on POD 21.
